Secondary care use only. 

Secondary care use only. 

Note: Prostin E2 Vaginal Gel and Vaginal Tablets are not bioequivalent.

Secondary care use only. 

Secondary care use only. 

Secondary care use only. 

Secondary care use in SCBU only.

Secondary care use only for closure of Patent Ductus Arteriosus (PDA) in premature neonates.

Secondary care use only. 

Secondary care use only. 

Secondary care use only. 

Alternative option if allergic to other topical products, dexterity problems with applicators or patient preference, in line with Oxfordshire HRT formulary and treatment guidance. 

APCO January 2016. 

For the treatment of bacterial vaginosis, in line with SCAN guidelines.

For the treatment of bacterial vaginosis, in line with SCAN guidelines.

Metronidazole is reserved to patients allergic to clindamycin. 

Monophasic low strength (21 day preparation).

Gedarel^® 20/150 is the most cost-effective preparation.

Monophasic low strength (21 day preparation).

Millinette^® 20/75 and Juliperla^® are the most cost-effective options.

Monophasic standard strength (21 day preparation).

Gedarel^® 30/150 and Cimizt^® are more cost-effective than Marvelon^®.

Monophasic standard strength (21 day preparation).

Millinette^® 30/75 and Sofiperla^® are the most cost-effective options. 

Monophasic standard strength (21 day preparation).

Monophasic standard strength (21 day preparation).

Monophasic standard strength (21 day preparation).

Cilique^® is the most cost-effective option. 

Cilest® will be discontinued with effect from July 2019. Current supplies are expected to last until mid-July 2019.

Phasic standard strength (28-day ‘Every day’ preparation).

Phasic standard strength (21 day preparation).

Phasic standard strength (21 day preparation).

TriRegol^® is more cost-effective than Logynon^®.

Monophasic standard strength (28-day ‘Every day’ preparation).

Microgynon 30 ED^® is more cost-effective than Femodene ED^®. 

Restricted use for women who are unable to tolerate alternative combined oral contraceptives.

APCO January 2011.

Evra^® patches should be restricted for use in women who are likely to comply poorly with combined oral contraceptives. 

 The Scottish Medicines Consortium (September 2003).

Second or third line option contraceptive when other methods have proved unacceptable.

APCO July 2009.

Prescribe generically.

Cerazette is 3.5 times more expensive than generic. 

APCO April 2020.

Provides contraception for up to 3 years. 

APCO September 2010. 

MHRA/CHM advice (June 2016):

There have been rare reports of Nexplanon^® implants reaching the lung via the pulmonary artery. An implant that cannot be palpated at its insertion site should be located and removed as soon as possible; if unable to locate implant within the arm, the MHRA recommends using chest imaging. Correct subdermal insertion reduces the risk of these events.

Intramuscular injection.

Subcutaneous injection.

For women requiring contraception for up to 4 years.

NB. Levonorgestrel-releasing intra-uterine devices vary in licensed indication, duration of use and insertion technique—the MHRA recommends to prescribe and dispense by brand name to avoid inadvertent switching.

Heavy Menstrual Bleeding: For women requiring HMB treatment for up to 4 years. 

APCO March 2018.

Contraception: For women requiring contraception for up to 5 years. Levonorgestrel-releasing intra-uterine devices vary in licensed indication, duration of use and insertion technique—the MHRA recommends to prescribe and dispense by brand name to avoid inadvertent switching.

Heavy Menstrual Bleeding: For women requiring HMB treatment for up to 5 years in line with local Care Pathway and Referral Criteria

Adjunctive progestogen in HRT treatment: in line with Oxfordshire HRT formulary and treatment guidance. Licensed for 4 years for HRT use. 

APCO January 2016. 

As an alternative to Levosert/ Mirena if:

• The woman has previously used Mirena IUS and experienced
  • discomfort
  • unacceptable symptoms
  • troublesome (symptomatic) ovarian cysts
• Loss of periods is unacceptable to the woman but heavy periods precludes use of copper IUD.
• History of breast cancer (for consultation at specialist contraception clinic and following involvement of oncologist)
• Woman wishes to avoid hormones because of unacceptable side effects with hormones previously.
• Failure at time of fitting to dilate internal os sufficiently for Mirena Jaydess IUS may be fitted because of narrower diameter.

APCO March 2018

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

Funded by Public Health - as per Family Planing Association Guidelines.

For use as emergency contraception for patients 72-120 hours post unprotected intercourse and when an intra-uterine device is not appropriate.

 APCO November 2009. 

Please note that Tamsulosin M/R capsules are first line.

Please note that Tamsulosin M/R capsules are first line.

Second-line option if tolterodine tolerated but not effective and mirabegron is contra-indicatedin line with The Management of Over Active Bladder Syndrome Guidelines.

APCO March 2017.

In line with The Management of Over Active Bladder Syndrome Guidelines.

• Second-line option if antimuscarinic drugs are contra-indicated
• Third-line option if antimuscarinic drugs have not been effective and mirabegron is not contra-indicated

NB. Mirabegron is contraindicated in patients with severe uncontrolled hypertension (systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg, or both). Blood pressure should be measured before starting treatment and monitored regularly during treatment, especially in patients with hypertension. MHRA Oct 2015.

APCO March 2017.

Oxybutynin should not be initiated for new patients.

People whose treatment with oxybutynin is not recommended in The Management of Over Active Bladder Syndrome Guidelines, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

APCO March 2017. 

Restricted for patients with swallowing difficulties in line with The Management of Over Active Bladder Syndrome Guidelines.

APCO March 2017. 

 Suitable for continuation in primary care following specialist initiation for paediatric patients with overactive bladder (tablets and liquid).

Approved subject to MMTC. Tablets are not licensed for use in children but licensed in adults for symptomatic treatment of urge incontinence and/or increased urinary frequency and urgency. The liquid is licensed for neurogenic detrusor overactivity (NDO) in paediatric patients aged 2 to 18 years.  In paediatric patients it is currently used by the specialist team as second/third line therapy following failure of either oxybutynin or tolterodine.

APCO November 2019.

 Solifenacin should not be initiated for new adult patients.

People whose treatment with solifenacin is not recommended in The Management of Over Active Bladder Syndrome Guidelines, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

Review continued benefit of antimuscarinic therapy and consider switching to tolterodine if this has not previously been tried.

APCO March 2017.

Patients currently taking trospium should be allowed to continue with this treatment.

Trospium may be an appropriate choice for patients taking multiple concomitant therapies as it does not interact with drugs metabolised by CYP 450 liver enzymes in line with The Management of Over Active Bladder Syndrome Guidelines.

APCO March 2017.

In line with Clinical Commissioning Policy 254A. 

For stress incontinence following recommendation from specialists only.

Duloxetine should not be prescribed for overactive bladder.

APCO July 2006.

Specialist use only for treating bladder pain syndrome in line with NICE TA610.

APCO January 2020.

Available to purchase over-the-counter for the relief of discomfort in mild urinary-tract infections. 

Available to purchase over-the-counter for the relief of discomfort in mild urinary-tract infections.

Secondary care use only for symptomatic relief in patients with interstitial cystitis (Hunner's ulcer).

Secondary care use only. 

Brands include Uro-Tainer Chlorhexidine^®.

Contains Citric acid 6%, gluconolactone 0.6%, magnesium carbonate 2.8% and disodium edetate 0.01%. Brands include OptiFlo R^®, Uriflex R^®, and Uro-Tainer^® Twin Solutio R. 

  For erectile dysfuction in line with Clinical Commissioning Policy 41F.

APCO May 2016.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

APCO November 2012.

  For erectile dysfuction in line with Clinical Commissioning Policy 41F.

APCO May 2016.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

APCO November 2012.

  For erectile dysfuction in line with Clinical Commissioning Policy 41F.

APCO May 2016.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

APCO November 2012.

 For erectile dysfunction in line with Clinical Commissioning Policy 41F.

APCO May 2016.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

 For erectile dysfunction in line with Clinical Commissioning Policy 41F.

APCO May 2016.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

 For symptoms associated with benign prostatic hyperplasia in line with NICE TA273.

APCO March 2013. 

 For erectile dysfunction in line with Clinical Commissioning Policy 41F.

APCO May 2016.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

  Second line treatment for erectile dysfunction equal to Caverject after oral therapies in line with Clinical Commissioning Policy 41F.

APCO July 2018.

  For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.

Secondary care use only. Unlicensed indication.

Patients with neurological or psychogenic impotence are more sensitive to the effect of papaverine than those with vascular abnormalities.

Secondary care use only. Unlicensed indication.